Qurrat-ul Ain, Nouman Abid, Zeeshan Asghar, Waleed Jameel, Asna Waseem, Maha Zaka.
Association of High Heels with Pain, Foot Disability and Quality of Life among Women of Pakistan.
Healer J Physiotherap Rehab Jan ;3(6):593-602.

Background: A large number of women are interested in wearing high heels to look attractive but it also places certain demands on the foot and ankle that leads to problems associated with their well-being and especially in elderly women. Objective: To determine the association of high heels with foot and ankle pain, disability and quality of life among women of Pakistan. Methods: This is a cross-sectional study that recruited two hundred and seven females wearing high heels from Lahore, Pakistan. The time duration of this study was six months after the approval of the synopsis. The females aged between 18 to 50 years wearing high heel shoes were included in the study. The foot and ankle disability index, the numeric pain rating scale and the EuroQol five-dimension healthcare questionnaire were used to measure the outcomes like disability of foot and ankle, foot pain and quality of life in women. A self-customized questionnaire was used to acquire the data related to the duration and frequency of wearing high heels. The association between different variables was calculated using Pearson`s correlation. Results: The average score of the foot and ankle disability index was 69.8. Pearson`s correlation between the height of heels and the foot and ankle disability Index score was reported to be -0.207 while the p-value was 0.002 showing a significant correlation. The average pain score was 3.52 on the pain numeric rating scale. The p-value was 0.002 and Pearson`s correlation between the height of the heel and pain showed a direct and significant correlation (p=0.206). The average score of quality of life was found to be 7.88 showing an indirect and significant correlation as the R-value was found to be -0.121. Conclusion: This present study concludes that there is a direct and significant correlation between the height of heels worn by women and pain in their heels, ankles and feet. It also shows that there is an inverse and significant correlation between the heel height and the foot and ankle disability index score while there is a direct and non-significant correlation between the heel height and quality of life score.

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